Hide the sharp objects

So here I am again, attempting to sort out my own views on the complicated debate of health care in this grand nation of ours. I have even been laying in bed thinking that my views on humanity and our country must be so radical that only I can see the forest through the spin-covered trees. I mean, I must be crazy to think that think that there is anyone else out in non-fiction land who recognizes the power of the individual versus the collective mindset. Yes, that must be it. I am a big crayon using , get the white coat, call Nurse Ratchet, get the electrodes ready, lobotomy candidate. Or am I?

I have been telling anyone who is polite enough to listen that we must begin treating healthcare like we treat any other consumer product (oh, the looks I get!) The idea that we spend more time shopping for a laptop than we do for a doctor is unsettling to say the least. How many young people even have the faintest idea what an EOB is? Why do we not question the double standard of what medical providers charge individuals versus insurance companies (PPO's, Medicare, etc.)? In short, why do we turn a blind eye to what providers charge for services?

The answer is two-fold. First, the vast majority (roughly 254 million) of us have insurance provided at so low a relative cost that we rarely pay attention to the true costs associated with our own wellness. Second, the roughly 34 million citizens who don't have insurance (According to the Census Bureau report “Income, Poverty, and Health Insurance Coverage in the United States,” published in August 2008, there were 45.6 million persons in the United States in 2007 who did not have health insurance. Of which, the report states that 9.7 million of these uninsured persons were not U.S. citizens.) either don't get the care they need or utilize emergency rooms at the expense of others. In any case, the way we play this game must be changed!

A vehicle has actually been provided for future generations to begin to free themselves of the yoke of both employers and the government when it comes to their health care. It is called the HSA. It provides individuals a way to manage their own costs and forces them to pay attention. Below is an excerpt from a brave article written by David Goldhill for The Atlantic. Of course, I take issue with his reference to "post-tax" dollars.
For years, a number of reformers have advocated a more “consumer-driven” care system—a term coined by the Harvard Business School professor Regina Herzlinger, who has written extensively on the subject. Many different steps could move us toward such a system. Here’s one approach that—although it may sound radical—makes sense to me.
First, we should replace our current web of employer- and government-based insurance with a single program of catastrophic insurance open to all Americans—indeed, all Americans should be required to buy it—with fixed premiums based solely on age. This program would be best run as a single national pool, without underwriting for specific risk factors, and would ultimately replace Medicare, Medicaid, and private insurance. All Americans would be insured against catastrophic illness, throughout their lives.
Proposals for true catastrophic insurance usually founder on the definition of catastrophe. So much of the amount we now spend is dedicated to problems that are considered catastrophic, the argument goes, that a separate catastrophic system is pointless. A typical catastrophic insurance policy today might cover any expenses above, say, $2,000. That threshold is far too low; ultimately, a threshold of $50,000 or more would be better. (Chronic conditions with expected annual costs above some lower threshold would also be covered.) We might consider other mechanisms to keep total costs down: the plan could be required to pay out no more in any year than its available premiums, for instance, with premium increases limited to the general rate of inflation. But the real key would be to restrict the coverage to true catastrophes—if this approach is to work, only a minority of us should ever be beneficiaries.
How would we pay for most of our health care? The same way we pay for everything else—out of our income and savings. Medicare itself is, in a sense, a form of forced savings, as is commercial insurance. In place of these programs and the premiums we now contribute to them, and along with catastrophic insurance, the government should create a new form of health savings account—a vehicle that has existed, though in imperfect form, since 2003. Every American should be required to maintain an HSA, and contribute a minimum percentage of post-tax income, subject to a floor and a cap in total dollar contributions. The income percentage required should rise over a working life, as wages and wealth typically do.
All noncatastrophic care should eventually be funded out of HSAs. But account-holders should be allowed to withdraw money for any purpose, without penalty, once the funds exceed a ceiling established for each age, and at death any remaining money should be disbursed through inheritance. Our current methods of health-care funding create a “use it or lose it” imperative. This new approach would ensure that families put aside funds for future expenses, but would not force them to spend the funds only on health care.
You can read the entire article here.

So there you have it. At least now I know that I am not the only wingnut out there. Who knows, maybe there are more of us. SCARY, ISN'T IT!

On a completely seperate matter (and one of local interest):

The Peoria Journal Star reported that Illinois American Water is asking the city council for a 28.39% rate increase. Interestingly enough when one looks at their rate request filed with the Illinois Commerce Commission the average increase for Peoria is 27.81%. Either way, at no point in the article does John Sharp mention the roughly $35 million capital improvements that must be made to the city's infrastructure at IAW's expense! Lucky for me, I was at the city council meeting the night that IAW made its presentation. They gave sound reasons and clearly demonstrated the need for a rate increase. Of course Councilwoman Van Auken took issue with their proposed 12% "return on investment" to their stockholders. Her jaw-dropping response of "WOW!" left little to be revealed about this woman and her apparent anti-business mindset. Of course, I am forgetting that in government, profit is a 4-letter word.
My brief glance at American Water's Annual Report (the parent company of IAW) leads me to believe that they have been nearly bankrupted by overregulation (on rates) and hamstrung from rebuilding their infrastructure (which they now must do in order to comply with EPA regulations). If you want to judge for yourself, the report is available here.

And another funny thing happened on the way to the forum...

At this same meeting, Councilman George Jacob asked about the possibility of reducing the salaries of the council members as a way of closing the $10 million budget gap the city of Peoria faces. Although this is undoubtedly a political gesture on his part, the ensuing discussion made me chuckle. Apparently, there is no legal provision in the statute that allows the council to reduce their own salaries. Councilwoman Van Auken even referred to the salaries that the council members receive as "teenie-weenie." Now call me crazy, but I don't really think that $14,000/year plus a $400/month car allowance for a part time job is a bad gig. Why do I get the feeling that this type of thing happens at every level of government?

Until next time...I hope that you will continue to: exercise your mind, work with purpose, love with reckless abandon, and whatever may come your way...do not shrug.

Matthew